Provider Demographics
NPI:1972114031
Name:GUICE, AMIE (MAED, RD, LD)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:
Last Name:GUICE
Suffix:
Gender:F
Credentials:MAED, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LUCERNE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6615
Mailing Address - Country:US
Mailing Address - Phone:205-447-7341
Mailing Address - Fax:
Practice Address - Street 1:301 LUCERNE BLVD
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-6615
Practice Address - Country:US
Practice Address - Phone:205-447-7341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2212133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered